选择性痔上黏膜切除吻合术治疗内痔的临床研究

Selective superior hemorrhoidal mucosa resection and anastomosis in the treatment of hemorrhoids clinical research

目的观察和评价选择性痔上黏膜切除吻合术(TST)治疗内痔的临床疗效。方法采用前瞻性、随机、对照的研究方法,将120例Ⅱ～Ⅳ度内痔患者随机分为TST组和PPH组,分别采用TST术和PPH术,比较观察两组患者的手术用时、术中出血量和术后便血、肿物脱出、肛门疼痛、尿潴留、肛门功能、吻合口狭窄等情况,并根据疗效评分标准进行评价。结果两组临床疗效比较,差异无统计学意义(P>0.05),两组手术时间比较,差异无统计学意义(P>0.05),但TST组在术中出血量、术后肛门疼痛、尿潴留、肛门功能、吻合口狭窄等方面明显优于PPH组(P<0.05)。结论 TST对Ⅱ～Ⅳ度内痔患者的治疗效果与PPH相似,且对肛门功能损伤小,术中出血少,术后疼痛轻,并发症少,能显著降低吻合口狭窄发生率。

Objective Observation and evaluation of selective superior hemorrhoidal mucosa resection and anastomosis for the treatment of hemorrhoids disease clinical curative effect. Methods A prospective, ran- domized, controlled study method, 120 cases of [[ ~ IV degree hemorrhoidal disease patients were random- ly divided into A group （test group） and group B （control group}, respectively, using TST technique and procedure for prolapse and hemorrhoids anastomosis （PPH）, compared with those observed in two groups of patients with operation time, intraoperative bleeding volume and postoperative blood in the stool, tumor prolapse, anal pain, urinary retention, anal function, anastomotic stenosis and so on, and according to the grading standards for evaluation of curative effect. Results Comparison of the clinical efficacy of the two groups, the difference was not statistically significant （ P ~ 0.05 ）, two groups of operation time, the difference was not statistically significant （ P ~0.05）, but TST groups in intraoperative blood loss, post- operative anal pain, urinary retention, anal function, anastomotic strictures are significantly better than that of group PPH （ P d0.05）. Conclusion TST on [[ ~ IV degree haemorrhoids therapeutic effects in pa- tients with PPH were similar, and the anal function less injury, less bleeding, less postoperative pain, less complications, can significantly reduce the incidence of anastomotic stenosis.